You must have JavaScript enabled to use this form. EDD Assistance Name Email Phone Address City Zip code Do you have an EDD Customer Account Number (CAN)? - Select -YesNo Last day of work Date case first filed Last Payment Date Describe the Issue What EDD program did you apply for? - Select -UnemploymentDisability Reason given by EDD for interruption of benefit payments - Select -ID VerificationSuspected/Potential FraudDisqualifiedWebsite issueNeed to reopen caseNo benefits leftOther or No Reason Given by EDD Issues with EDD - Select -Unable to Certify for BenefitsFile a new claim issueExtension PendingPayments Pending
